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. 2020 Jul;2(7):e376-e379.
doi: 10.1016/S2665-9913(20)30137-5. Epub 2020 May 15.

Novel paediatric presentation of COVID-19 with ARDS and cytokine storm syndrome without respiratory symptoms

Clare E Pain  1 , Susanna Felsenstein  2 , Gavin Cleary  1 , Sarah Mayell  3 , Karsten Conrad  4 , Srikrishna Harave  5 , Phuoc Duong  6 , Ian Sinha  3 , David Porter  2 , Christian M Hedrich  7
Affiliations

Novel paediatric presentation of COVID-19 with ARDS and cytokine storm syndrome without respiratory symptoms

Clare E Pain et al. Lancet Rheumatol. 2020 Jul.
No abstract available

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Figures

Figure
Figure
Clinical findings in a 14-year-old patient with COVID-19 and cytokine storm syndrome Although chest radiography was normal at admission (day −2; A, left panel), follow-up imaging 4 days later (A, right panel) showed dense infiltrates suggestive of early-stage acute respiratory distress syndrome in the context of COVID-19. A widespread maculopapular blanching rash (B) appeared on the second day after admission (day 0) and improved after initiation of anakinra treatment. Axial CT on day 0 (C), when anakinra treatment was started, shows interlobular and intralobular septal thickening and rounded ground-glass opacities, predominantly in a peripheral distribution in both lungs; small peripheral or subpleural areas of subsegmental collapse or consolidation are noted, particularly at the bases. Axial CT on day 11 (D) shows a severely dilated left mainstem coronary artery (arrow) and proximal left anterior descending artery (Z-score 6·6 on echocardiography [not shown] and CT). Laboratory and clinical (core temperature) variables (E) indicate rapid and sustained improvement temporally associated with anakinra treatment (started day 0).
See this image and copyright information in PMC

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